Provider Demographics
NPI:1861969271
Name:SANCHEZ, JOSE A (IDMT-PARAMEDIC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:IDMT-PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4262 DUDLEY DR NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5604
Mailing Address - Country:US
Mailing Address - Phone:360-338-1124
Mailing Address - Fax:
Practice Address - Street 1:309 PITSENBARGER BLVD
Practice Address - Street 2:
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98438-1201
Practice Address - Country:US
Practice Address - Phone:603-381-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
M5098459146L00000X
1710I1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic